Retrospective Validation of the San Francisco Syncope Rule for Predicting Serious Outcomes in a Korean Emergency Department

PURPOSE: Syncope in a common condition that is typically benign but is occasionally associated with mortality. We conducted a retrospective validation of the San Francisco Syncope Rule (SFSR) for use in identifying emergency department (ED) syncope patients with short-term serious outcomes. METHODS: We studied 131 syncope patients who were admitted to or visited the out-patient department within 1 month of an ED visit related to syncope from January to December 2010. Patients meeting the inclusion criteria as defined in the SFSR derivation were evaluated for 5 previously derived predictor variables: abnormal electrocardiography (ECG), shortness of breath, hematocrit <30%, triage systolic blood pressure <90 mm Hg, and a history of congestive heart failure. Predetermined outcome measures as defined by the SFSR included death, myocardial infarction, arrhythmia, pulmonary embolism, stroke, subarachnoid hemorrhage, significant hemorrhage, or any condition causing or likely to cause a return ED visit and hospitalization, or related event. RESULTS: The patient group consisted of 63 males and 68 females with an average age of 56 years. 35(26.7%) patients met the predetermined criteria for serious outcome. 10 of 35(28.6%) patients with a serious outcome were not identified as high risk using the rule. The rule performance for predicting serious outcomes included a sensitivity of 71.4% (95% confidence interval (CI), 56% to 86%), specificity of 69.8% (95% confidence interval (CI), 69% to 70%) and positive predictive value of 47.3%. CONCLUSION: In this retrospective validation study in Korea, the SFSR performed with comparable specificity but with significantly lower sensitivity than reported in the original study. Implementing the rule would significantly increase admission rates.

Effect of dietary supplementation of grape skin and seeds on liver fibrosis induced by dimethylnitrosamine in rats

Grape is one of the most popular and widely cultivated fruits in the world. Although grape skin and seeds are waste product of the winery and grape juice industry, these wastes contain large amounts of phytochemicals such as flavonoids, phenolic acids, and anthocyanidins, which play an important role as chemopreventive and anticancer agents. We evaluated efficacies of grape skin and seeds on hepatic injury induced by dimethylnitrosamine (DMN) in rats. Treatment with DMN significantly increased levels of serum alanine transaminase, aspartate transaminase, alkaline phosphatase, and bilirubin. Diet supplementation with grape skin or seeds (10% daily for 4 weeks) prevented these elevations. The grape skin and seeds also restored serum albumin and total protein levels, and reduced the hepatic level of hydroxyproline and malondialdehyde. Furthermore, grape skin and seeds reduced DMN-induced collagen accumulation, as estimated by histological analysis of liver tissue stained with Sirius red. Grape skin and seeds also reduced hepatic stellate cell activation, as assessed by alpha-smooth muscle actin staining. In conclusion, grape skin and seeds exhibited in vivo hepatoprotective and antifibrogenic effects against DMN-induced liver injury, suggesting that grape skin and seeds may be useful in preventing the development of hepatic fibrosis.

The Effects of Growth Inhibition and Quinone Reductase Activity Stimulation of Celastrus Orbiculatus Fractions in Various Cancer Cells

Celastrus orbiculatus (CO) has been used as a traditional herb medicine to treat fever, chill, joint pain, edema, rheumatoid arthritis and bacterial infection in China and Korea. In this study, we investigated anticarcinogenic effects of Celastrus orbiculatus (CO). CO was extracted with methanol (COM), and then further fractionated into four different types: methanol (COMM), hexane (COMH), butanol (COMB) and aqueous (COMA) partition layers. We determined the cytotoxicity of these four partitions in four kind of cancer cell lines, such as HepG2, MCF-7, HT29 and B16F10 Cells by MTT assay. Among various partition layers of CO, the COMM showed the strongest cytotoxic effects on cancer cell lines we used. We also observed quinone reductase (QR) induced effects in all partition layers of CO on HepG2 cells. The QR induced effects of COMM on HepG2 cells at 80 microgram/mL concentration indicated 3.28 to a control value of 1.0. The COMM showed the highest induction activity of quinone reductase on HepG2 cells among the other partition layers. Although further studies are needed, the present work suggests that CO may be a chemopreventive agent for the treatment of human cells.

Cytotoxicity and Quinone Reductase Activity Stimulating Effects of Fin of Thunnus Thynnus Extracts in Various Cancer Cells

In this study, we investigated the anticancer activity of the fin of Thunnus Thynnus (TT ). TT was extracted with methanol (TTM ), and then further fractionated into four subfractions by using solvent partition method, affording hexane (TTMH ), methanol (TTMM ), butanol (TTMB )and aquous (TTMA )soluble fractions. We determined the cyto-toxicity of these four fractions in four kind of cancer cell lines, such as HepG2, MCF-7, B16-F10 and HT29 by MTT assay. The TTMM showed the strongest cytotoxic effect at the concentration of 150 microgram/mL, displaying 95% on the HepG2 cell lines and 82% on MCF-7 cell line. The morphological changes such as membrane shirinking and blebbing of cells were also observed by TTMM treatment in HT29 cell. In addition, we observed that quinone reductase (QR ) activity was elevated by only TTMM and TTMH treatments in HepG2 cell. QR activity was increased to around 2.0 and 1.8 times in TTMM and TTMH treated HepG2 cell at 100 microgram/mL, respectively, compared to that in control. Although further studies are needed, the present work could suggest that the fin of TT has a potential to be usable as a chemo-preventive agent against cancer.

The Effects on Antimicrobial and Cytotoxicity of Hijikia Fusiformis Fraction

In this study, we investigated antimicrobial and cytotoxicity effects to each fraction extracted from Hizikia fusiformis (HF), which were extracted methanol (HFM)and then the extract was fractionated into four different types: hexane (HFMH), methanol (HFMM), butanol (HFMB) and aquous (HFMA) partition layers. We determined the cytotoxic effect of these layers on human cancer cells by MTT assay. Among various partition layers of HF, the HFMB and HFMM were showed the strong cytotoxic effects on cancer cell lines we used. The quinone reductase (QR) induced activity of the HFMB on HepG2 cells at 150 microgram/mL concentration was 2.63 times more effective compared to the control value of 1.0. Although further studies are needed, the present work suggests that HF maybe a chemopreventive agent for the treatment of human cancer cells.

The Antioxidative and Antimicrobial Effects of Gloiopeltis Tenax

In this study, we investigated the antioxidative and antimicrobial activities of red algae Gloiopeltis tenax (GT). GT was extracted with methanol and then further fractionated it into four different types: methanol (GTMM), hexane (GTMH), butanol (GTMB) and aqueous (GTMA) soluble fractions. The antioxidant activity of the fractions from GT was investigated by measuring the scavenging activities of GT against reactive oxygen species (ROS) and reactive nitrogen species (RNS). Among the four fractions of GT, GTMM and GTMB showed a marked scavenging effect against ROS, but they displayed very low levels of the scavenging effect against RNS. The antimicrobial activity was increased in proportion to its concentration by the paper disc method. Among the various solvent layers, the GTMM and GTMB showed strong antimicrobial activities.

The Growth Inhibitory Effects of Atrina Pecitinata Fractions on Cancer Cell Lines

We investigated the growth inhibitory effects of Atrina pecitinata (AP) on the proliferation in human cancer cell lines in vitro. AP was extracted with methanol which was further fractionated into four diffferent types: methanol (APMM), haxane (APMH), butanol (APMB), and aquous layers (APMA). Among various partition layers, the APMM showed the strongest cytotoxic effects on all cancer cell lines which we used. In the MTT assay of AP fractions, the growth inhibitory effects was increased in proportion to its concentration. We observed quinone reductase (QR) induced effects in all fraction layers of AP on HepG2 cells. The QR induced effects of APMM on HepG2 cell at 80 microgram/mL concentration indicated 2.0 with a control value of 1.0.

A Study on the Effects of Anticarcinogenic Activity of Chondria Crassicaulis

In this study, we investigated the biological activity of Chondria crassicaulis (CC) on the human cancer cells. CC was extracted with methanol and further fractionated into four diffferent types: hexane (CCMH), methanol (CCMM), butanol (CCMB), and aqueous (CCMA) partition layers. We determined the cytotoxic effect of these layers on human cancer cells by MTT assay. Among various partition layers of CC, the CCMM and CCMB showed the strong cytotoxic effects at 150 micrometer/ml which resulted 98.91%, 92.96% on HeLa cell lines and 95.47%, 77.05% on MCF-7 cell lines. And, the anti-proliferative effect of CC was accompanied by a marked inhibition of cyclooxygenase (COX-2), Caspase-3 and IAP (cIAP-1, cIAP-2 and XIAP) protein and concomitant induction of p53, p21 and Survivin protein. However, CC did not affect the level of Bax, Bcl-2 and Bcl-XL protein. Also, we observed quinone reductase (QR) induced effects in all fraction layers of CC on HepG2 cells. The QR induced effects of the CCMH and CCMM on HepG2 cells at 120 micrometer/mL concentration indicated 3.73 and 2.45 with the control value of 1.0. Although further studies are needed, the present work suggests that CC may be a chemopreventive agent for the treatment of human cancer cells.